scholarly journals Gestational Diabetes Mellitus: Screening and Outcomes in Southern Italian Pregnant Women

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Carmelo Capula ◽  
Eusebio Chiefari ◽  
Anna Vero ◽  
Biagio Arcidiacono ◽  
Stefania Iiritano ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
High Risk ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
International Association ◽  
Study Groups ◽  
Large For Gestational Age ◽  
Iadpsg Criteria

Recent Italian guidelines exclude women <35 years old, without risk factors for gestational diabetes mellitus (GDM), from screening for GDM. To determine the effectiveness of these measures with respect to the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria, we evaluated 2,448 pregnant women retrospectively enrolled in Calabria, southern Italy. GDM was diagnosed following the IADPSG 2010 criteria. Among 538 women <35 years old, without risk factors, who would have not been tested according to the Italian guidelines, we diagnosed GDM in 171 (31.8%) pregnants (7.0% of total pregnants). Diagnosis was made at baseline (55.6%), 1 hour (39.8%), or 2 hours (4.7%) during OGTT. Despite of appropriate treatment, GDM represented a risk factor for cesarean section, polyhydramnios, increased birth weight, admission to neonatal intensive care units, and large for gestational age. These outcomes were similar to those observed in GDM women at high risk for GDM. In conclusion, Italian recommendations failed to identify 7.0% of women with GDM, when compared to IADPSG criteria. The risk for adverse hyperglycaemic-related outcomes is similar in low-risk and high-risk pregnants with GDM. To limit costs of GDM screening, our data suggest to restrict OGTT to two steps (baseline and 1 hour).

scholarly journals Fourfold increase in prevalence of gestational diabetes mellitus after adoption of the new International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria

2017 ◽  
Vol 45 (3) ◽  
Author(s):  
Evelyn A. Huhn ◽  
Nadine Massaro ◽  
Simone Streckeisen ◽  
Gwendolin Manegold-Brauer ◽  
Andreas Schoetzau ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
International Association ◽  
Study Groups ◽  
Absolute Increase ◽  
Period 2 ◽  
Iadpsg Criteria ◽  
Diabetes And Pregnancy

AbstractBackground:The aim was to evaluate the influence of the new International Association of Diabetes and Pregnancy Study Groups (IADPSG) guidelines for screening of gestational diabetes mellitus (GDM) on GDM prevalence in a cohort from a Swiss tertiary hospital.Methods:This was a retrospective cohort study involving all pregnant women who were screened for GDM between 24 and 28 weeks of gestation. From 2008 until 2010 (period 1), a two-step approach with 1-h 50 g glucose challenge test (GCT) was used, followed by fasting, 1- and 2-h glucose measurements after a 75 g oral glucose tolerance test (OGTT) in case of a positive GCT. From 2010 until 2013 (period 2), all pregnant women were tested with a one-step 75 g OGTT according to new IADPSG guidelines. In both periods, women with risk factors could be screened directly with a 75 g OGTT in early pregnancy.Results:Overall, 647 women were eligible for the study in period 1 and 720 in period 2. The introduction of the IADPSG criteria resulted in an absolute increase of GDM prevalence of 8.5% (3.3% in period 1 to 11.8% in period 2).Conclusions:The adoption of the IADPSG criteria resulted in a considerable increase in GDM diagnosis in our Swiss cohort. Further studies are needed to investigate if the screening is cost effective and if treatment of our additionally diagnosed GDM mothers might improve short-term as well as long-term outcome.

MATERNAL GESTATIONAL DIABETES MELLITUS AND OFFSPRING BODY MASS INDEX FROM 1 TO 4 YEARS

2020 ◽  
Vol 26 (6) ◽  
pp. 619-626
Author(s):  
Xiulin Shi ◽  
Dongmei Wang ◽  
Mingzhu Lin ◽  
Weijuan Su ◽  
Liying Wang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Body Mass Index ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Body Mass ◽  
International Association ◽  
Study Groups ◽  
Z Score ◽  
Birth Registry ◽  
Iadpsg Criteria

Objective: Using the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria to diagnose gestational diabetes mellitus (GDM), the association between GDM and offspring body mass index (BMI) gains in early childhood in China remains unclear. We aimed to assess the association between GDM diagnosed by the IADPSG criteria and BMI gain and the risk for overweight/obesity in offspring from 1 to 4 years. Methods: This prospective cohort study was based on the healthcare records data from the Medical Birth Registry in Xiamen, China. We included 10,412 mother-child pairs tested for GDM using IADPSG criteria. Results: A total of 1,786 (17.2%) offspring were exposed to GDM. The offspring exposed to GDM had higher mean BMI Z-score (difference, 0.07; 95% confidence interval [CI], 0.02 to 0.12) and risk for overweight/obesity (odds ratio [OR], 1.22; 95% CI, 1.06 to 1.40) compared to those unexposed to GDM from 1 to 4 years of age. However, after adjustment for maternal pre-pregnancy BMI (Model 2), these associations attenuated towards the null (difference in BMI Z-score, 0.02; 95% CI, −0.03 to 0.07; OR for overweight/obesity, 1.09; 95% CI, 0.95 to 1.25). Conclusion: The associations between GDM diagnosed using IADPSG criteria and BMI Z-score and the risk for overweight/obesity in offspring at the age of 1 to 4 years were largely explained by maternal pre-pregnancy BMI. Reducing the prevalence of childhood overweight and obesity in China should focus on maternal weight status before pregnancy, in addition to glycemia during pregnancy. Abbreviations: BMI = body mass index; CI = confidence interval; GDM = gestational diabetes mellitus; IADPSG = International Association of Diabetes and Pregnancy Study Groups; LGA = large for gestational age; MBRX = Medical Birth Registry in Xiamen; OGTT = oral glucose tolerance test; OR = odds ratio

scholarly journals Comparative analysis of current diagnostic criteria for gestational diabetes mellitus

2012 ◽  
Vol 5 (2) ◽  
pp. 71-77 ◽  
Author(s):  
Mariya V Boyadzhieva ◽  
Iliana Atanasova ◽  
Sabina Zacharieva ◽  
Tsvetalina Tankova ◽  
Violeta Dimitrova
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Diagnostic Criteria ◽  
International Association ◽  
Study Groups ◽  
World Health ◽  
Oral Glucose ◽  
Significant Difference ◽  
Iadpsg Criteria

Background To compare current guidelines for diagnosis of gestational diabetes mellitus (GDM) and to identify the ones that are the most relevant for application among pregnant Bulgarian population. Methods A total of 800 pregnant women at high risk for GDM underwent 75 g oral glucose tolerance test between 24 and 28 weeks of gestation as antenatal screening. The results were interpreted and classified according to the guidelines of the International Association of Diabetes and Pregnancy Study Groups (IADPSG), American Diabetes Association (ADA), Australasian Diabetes in Pregnancy Society, Canadian Diabetes Association, European Association for the Study of Diabetes, New Zealand Society for the study of Diabetes and World Health Organization. Results The application of different diagnostic criteria resulted in prevalences of GDM between 10.8% and 31.6%. Using any two sets of criteria, women who were classified differently varied between 0.1% and 21.1% ( P < 0.001).The IADPSG criteria were the most inclusive criteria and resulted in the highest prevalence of GDM. There was a significant difference in the major metabolic parameters between GDM and control groups, regardless of which of the diagnostic criteria applied. GDM diagnosed according to all criteria resulted in increased proportion of delivery by caesarean section (CS). However, only ADA and IADPSG criteria identified both increased macrosomia (odds ratio, 2.36; 2.29) and CS rate. Conclusion The need for GDM screening is indisputable. In our view, the new IADPSG guidelines offer a unique opportunity for a unified national and global approach to GDM.

scholarly journals The Risk for Glucose Intolerance after Gestational Diabetes Mellitus since the Introduction of the IADPSG Criteria: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 8 (9) ◽  
pp. 1431 ◽  
Author(s):  
Benhalima ◽  
Lens ◽  
Bosteels ◽  
Chantal
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Diagnostic Criteria ◽  
Glucose Intolerance ◽  
International Association ◽  
Study Groups ◽  
Increased Risk ◽  
Iadpsg Criteria ◽  
History Of

The aim of the study was to assess the postpartum risk for glucose intolerance since the introduction of the ‘International Association of Diabetes and Pregnancy Study Groups’ (IADPSG) criteria for gestational diabetes mellitus (GDM). Studies published since 2010 were included, which evaluated the risk for type 2 diabetes mellitus (T2DM), impaired glucose tolerance (IGT), and cardiovascular (CV) events in women with previous GDM compared to normal glucose tolerant women. We included forty-three studies, evaluating 4,923,571 pregnant women of which 5.8% (284,312) had a history of GDM. Five studies used IADPSG criteria (n = 6174 women, 1314 with GDM). The overall pooled relative risk (RR) for postpartum T2DM was 7.42 (95% CI: 5.99–9.19) and the RR for postpartum T2DM with IADPSG criteria was 6.45 (95% CI: 4.74–8.77) compared to the RR of 9.08 (95% CI: 6.96–11.85; p = 0.17) for postpartum T2DM based on other diagnostic criteria. The RR for postpartum IGT was 2.45 (95% CI: 1.92–3.13), independent of the criteria used. None of the available studies with IADPSG criteria evaluated the risk for CV events. Women with a history of GDM based on the IADPSG criteria have a similarly increased risk for postpartum glucose intolerance compared to GDM based on other diagnostic criteria. More studies with GDM based on the IADPSG criteria are needed to increase the quality of evidence concerning the long-term metabolic risk.

scholarly journals Clinical Implications of the NICE 2015 Criteria for Gestational Diabetes Mellitus

2018 ◽  
Vol 7 (10) ◽  
pp. 376 ◽  
Author(s):  
Meena Bhatia ◽  
Lucy Mackillop ◽  
Katy Bartlett ◽  
Lise Loerup ◽  
Yvonne Kenworthy ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
International Association ◽  
Fasting Blood Glucose ◽  
Large For Gestational Age ◽  
P Value ◽  
Perinatal Complications ◽  
Neonatal Complications ◽  
Iadpsg Criteria

Background: In response to concerns that the International Association of Diabetes in Pregnancy Study Group (IADPSG) criteria labeled too many women with gestational diabetes mellitus (GDM) without evidence of clinical or economic benefit, NICE recommended a change in diagnostic criteria in 2015. Aim: To compare diabetes associated maternal and neonatal complications in pregnancies complicated by GDM diagnosed using IADPSG criteria only, to those with GDM diagnosed using both IADPSG and NICE 2015 criteria. GDM screening was risk factor based. Methods: This was a secondary analysis of a trial of women with GDM diagnosed by the IADPSG criteria (fasting blood glucose (BG) ≥ 5.1 mmol/L, 1 h ≥ 10.0 mmol/L and 2 h ≥ 8.5 mmol/L). Outcomes were compared for two groups: NICE + IADPSG defined as those with GDM diagnosed by both the NICE 2015 and IADPSG criteria (fasting BG ≥ 5.6 mmol/L, 2 h ≥ 8.5 mmol/L); and IADPSG-ONLY (fasting BG 5.1 mmol/L to 5.5 mmol/L, and/or 1-hour ≥10.0 mmol/L, and 2 h ≥ 8.5 mmol/L). We were not able to obtain data for women with a 2-h value between BG 7.8–8.4 mmol/L (i.e., NICE-ONLY; NICE 2015 positive and IADPSG negative). All women were treated for GDM using targets of fasting BG < 5.3 mmol/L and 1-h post prandial BG < 7.8 mmol/L respectively. Results: Of 159 women, 65 (40.9%) were NICE + IADPSG and 94 (59.1%) IADPSG-ONLY. Hypoglycaemic medication use was similar in both groups: 52.3% NICE + IADPSG, 46.8% IADPSG-ONLY, OR 1.0 (0.5–1.9). The IADPSG-ONLY group delivered later than the NICE + IADPSG group; 39.0 weeks (sd 1.4) compared to 38.2 weeks (sd 2.5), p value 0.02. Fewer caesarean sections occurred in IADPSG-ONLY group 30.9% vs. 52.3%, OR 0.4 (0.2–0.9). Birthweight, large for gestational age, and other neonatal complications were not significantly different between groups. Conclusions: Gestational diabetes-associated perinatal complications were similar in both groups. The IADPSG criteria detect women with evidence of ongoing hyperglycaemia who may benefit from treatment during pregnancy.

scholarly journals Diabetes Mellitus Gestacional com ênfase nas Gestantes de Alto Risco / Gestational Diabetes Mellitus with an emphasis on High-Risk Pregnant Women

2021 ◽  
Vol 15 (58) ◽  
pp. 278-291
Author(s):  
Ana Luiza Almeida da Silva ◽  
Ana Paula Silveira Santos ◽  
Simei Gleide Silva Matos ◽  
Matheus Santos Marques
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
High Risk ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Public Health Problem ◽  
High Risk Pregnancy ◽  
Mortality Factors ◽  
Risk Pregnancy

Resumo: Considerando o Diabetes Mellitus um problema de saúde pública e sendo um dos principais fatores de morbimortalidade no Brasil, torna-se relevante destacar o aumento de casos ocorridos do DMG em gestantes de alto risco. Esta pesquisa teve por objetivo: investigar o perfil clínico do diabetes mellitus gestacional (DMG) e como o mesmo pode levar a uma gravidez de alto risco, sua associação aos fatores de riscos e suas principais complicações. Quanto à metodologia é exclusivamente de caráter bibliográfico. Foi feita uma pesquisa de revisão bibliográfica, a qual utilizou fontes de internet, onde foram aplicados critérios de inclusão e exclusão, chegando a um total de 12 artigos selecionados. A partir desses artigos, a pesquisa verificou que os fatores de riscos associados ao DMG e suas complicações, fazem correlação com a gravidez de alto risco. Assim, se faz necessário o rastreamento e monitoramento, a prevenção, o diagnóstico e tratamento do DMG tanto para a mãe quanto para o feto. Logo é fundamental a atuação do farmacêutico na equipe multidisciplinar, pois contribui desde a gestão, aquisição até a dispensação eficiente dos medicamentos auxiliando de forma a reduzir os riscos, promovendo atenção, cuidado e uma saúde de qualidade às gestantes. Palavras Chave: Diabetes Mellitus. Diabetes Mellitus Gestacional. Gravidez de Alto Risco. Abstract: Considering Diabetes Mellitus a public health problem and one of the main morbidity and mortality factors in Brazil, it is relevant to highlight the increase in cases of GDM in high-risk pregnant women. This research aimed to: investigate the clinical profile of gestacional diabetes mellitus (GDM) and how it can lead to a high-risk pregnancy, its association with risk factors and its main complications. As for the methodology, it is exclusively bibliographic in nature. A bibliographic review research was carried out, using internet  sources,  where inclusion   and exclusion  criteria   were applied, reaching a total of  12 selected articles. From these articles, the research found that the risk factors associated with GDM and its complications are correlated with high-risk pregnancy. Thus, it is necessary the tracking and monitoring, prevention, diagnosis and treatment of GDM for both mother and fetus. Therefore, the role of the pharmacist in the multidisciplinary team is essential, as he contributes from the management, acquisition to the efficient dispensing of medicines, helping to reduce risks, promoting attention, care and quality health for pregnant women. Keywords: Diabetes Mellitus. Gestational Diabetes Mellitus. High-risk Pregnancy.

Sign in / Sign up

Export Citation Format

Share Document